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A 59-year-old white woman with a history of chronic headaches and sinusitis presented with a new onset of vertigo. A head and neck examination demonstrated no facial asymmetry or cranial nerve abnormalities. Sinonasal endoscopy showed postsurgical changes from previous sinus surgery. Examination of the mucosa revealed significant edema without evidence of purulence. Otoscopy demonstrated intact tympanic membranes with no effusion. Negative or normal laboratory findings included calcium, parathyroid hormone, angiotensin-converting enzyme, cytoplasmic and perinuclear antineutrophil cytoplasmic autoantibody, total serum protein, and vitamin D levels.
Suh JD, Ishiyama A, Bhuta S, Wang MB. Radiology Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2010;136(2):200. doi:10.1001/archoto.2009.217-a